Tag: obrzęk limfatyczny

The assessment of the early rehabilitation’s impact on the level of disorders occurring and the process of reinnervation, on the example of facial twigs of the motor nerve in patients with craniofacial injuries

Szymon Tyszkiewicz, Patrycja Ujma, Dominik Szczeciński, Klaudia Szczygieł, Marcin Kozakiewicz


Szymon Tyszkiewicz, Patrycja Ujma, Dominik Szczeciński, Klaudia Szczygieł, Marcin Kozakiewicz – The assessment of the early rehabilitation’s impact on the level of disorders occurring and the process of reinnervation, on the example of facial twigs of the motor nerve in patients with craniofacial injuries. Fizjoterapia Polska 2022; 22(4); 128-141

DOI: https://doi.org/10.56984/8ZG1A6t5I

Abstract
Introduction. Lymphoedema of the skull’s facial part is one of the main complications observed in a patient after surgical treatment of disorders of this area. Another noticeable and frequently reported complication by the patient is irregularities in facial expression muscles’ work. A relationship between them and reducing edema performed in patients in the first days after surgery will reduce the noted disturbances in motor branches’ function.
Aim. To investigate the impact of early swelling reduction on the extent of nervous system disorders and its reinnervation rate.
Materials and methods. Patients of the Maxillofacial Surgery Clinic of the University Clinical Hospital of the Military Medical Academy in Łódź were enrolled in the study. The study was conducted on 60 people who underwent maxillofacial surgery procedures from February to December 2019. Lymphatic drainage and dynamic taping were used to reduce patients’ edema. Forty-five people were divided into three equal groups. Fifteen patients constituted the comparative group. The research tools were a survey created following the author’s idea, linear measurements for measuring edema, and the Pietruski scale for assessing the state of reinnervation imaged by mimic muscle motility. On the first day after surgery, patients were examined four times, then on the third and seventh day after surgery, and finally four months after surgery.
Results. The use of anti-edema therapy noticeably (from 2-5 points on the Pietruski scale) reduces the disturbances in facial expression muscles’ function. The difference has been visible already on the third day after surgery. Regarding the patient’s pain, the lack of manual lymphatic system development resulted in pain sensations remaining in each of the three tests performed. The occurrence of edema, pain level, and level of facial expression muscle disorders were similar between groups and made the following research objective in terms of observed relationships.
Conclusions. The level of disturbances in the area of the mobility of expressive facial muscles (based on Pietruski scale) indicates that the implementation of anti edematous therapy, and thus the reduction of excess lymph, already in the first days after surgery provides a reduction of disorders of conduction of efferent impulses of motor fibers, appearing already in the first days after surgery. Increased drainage rate also accelerates the reinnervation process, shortens it by several weeks, and reduces pain symptoms.

Key words:
reinnervation, facial nerve, lymphatic oedema, dental physiotherapy

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The effectiveness of conservative methods of rehabilitation (PT) in treatment of lymphoedema after mastectomy operation

Dorota Hanasz-Sokołowska, Urszula Kaźmierczak, Wojciech Hagner, Magdalena Kaźmierczak

Dorota Hanasz-Sokołowska, Urszula Kaźmierczak, Wojciech Hagner, Magdalena Kaźmierczak – The effectiveness of conservative methods of rehabilitation (PT) in treatment of lymphoedema after mastectomy operation. Fizjoterapia Polska 2006; 6(1); 67-72

Abstract

Background. The aim of our research was to evaluate the effectivness of two methods of treatment of the lymphoedema after mastectomy operation. Method number 1 – classic method in treatment of lymphoedema after mastectomy operation. Treatment by using: lymphatic drainage, pneumatic massage, exercises in series 10/ 3 times a week. Method number 2 – complex methods that helps in restoration of patency: lymphatic drainage, pneumatic massage, exercises, bandaimy the upper limb, where lymphoedema appeared in series 10, 5 times a week. The examination aim was to evaluate subside of pain druing process of decreasing of lymphoedema. Material and methods. In our research we examinated patients with lymphoedema of upper limb after mastectomy operation, who were treated in Wojewódzkie Centrum Onkologii in Gdansk. Patients were devided into two groups of 15 patients each. In first group patients were treated in serie of 10, 3 times a week by classic method used: lymphatic drainage, pneumatic massage, exercises. In second group patients were treated by complex method of treatment, in series of 10, 5 times a week, by using classic treatment and adding the bandainy of upper limb, were lymphoedema appeared after operation. Results. Treatment of lymphoedema by using two methods had influence on our final results. Lymphoedema in group number 1, who were treated by classic method was located on level of forearm and elbow point. Lymphoedema in group number 2, who were treated by complex method was located over decvanon of vinov bone. Conclusions. Our research shows that conservative methods of rehabilitation had influence in process of decreasing lymphoedema, also helped to relieve pain in upper limb. The complex method is very effective treatment in lymphotic restor patency process.

Key words:
mastectomy, lymphoedema, rehabilitation
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The influence of kinesiotaping applications on lymphoedema of an upper limb in women after mastectomy

Anna Lipińska, Zbigniew Śliwiński, Wojciech Kiebzak, Tomasz Senderek, Janusz Kirenko

Anna Lipińska, Zbigniew Śliwiński, Wojciech Kiebzak, Tomasz Senderek, Janusz Kirenko – The influence of kinesiotaping applications on lymphoedema of an upper limb in women after mastectomy. Fizjoterapia Polska 2007; 7(3); 258-269

Abstract
Background. Doctor Kenzo Kase is a creator of the method Kinesio Taping. In the course of years-lasting experiences he worked out a plas-ter called Kinesio Tex, which applied during therapy in the form of application affects a patient not only during a visit, but also after its finishing supporting autotherapy of an organism. The usage of the method of kinesiotaping at women after mastectomy influences on the decrease of oedema lymphatic and normalization of muscular tension. Material and methods. Researches were conducted in Rehabilitation Ward of Swiętokrzyskie Oncology Centre in the period from November 2006 to February 2007. The group consisted of 25 women at the age of 40 to 70 years old (the average of their age 55,16 years) treated because of breast cancer with oedema lymphatic. Every woman taking part in the experiment was subjected to kinesiotaping therapy. The research of measurement of oedema lymphatic, the muscular strength of indicated muscular structures as well as the range of movement in a humeral joint, elbow joint, wristradial joint were carried out in four series: before the first application (research I), before every next (research II, III) and after the last application (research IV). In the break between researches a patient was obliged to follow rules referring to behaviour after mastectomy. Results. Assessment of the efficiency of an upper limb at women after mastectomy shows that a 20 – day cycle of improving with the use of lymphatic applications of the kinesiotaping method considerably reduced oedema lymphatic which 24%, increases range of motion 20 % and normalization of muscular tension brings satisfactory therapeutic effects. Conclusions. Lymphatic applications accelerate lymphatic and venous microcirculation, reduces the stasis of lymph in intercellular spaces. Decrease of oedema contributes to the improvement of movement range in all joints of an upper limb and normalization of muscular tension con-tributing to the increase of muscular strengt.
Key words:
Kinesio Taping Method, lymphatic applications, mastectomy, lymphoedema
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The influence of systematic physiotherapy on upper limb function in post-mastectomy women

Ewa Puszczałowska-Lizis, Paweł Lizis

Ewa Puszczałowska-Lizis, Paweł Lizis – The influence of systematic physiotherapy on upper limb function in post-mastectomy women. Fizjoterapia Polska 2011; 11(1); 41-48

Abstract
The aim of this paper was to evaluate the effect of physiotherapy on upper limb function in post-mastectomy women. Thirty-three women attending the Amazons Post-Mastectomy Women’s Club at the Holy Cross Cancer Centre in Kielce were examined on two occasions at three months’ interval. The participants were divided into Group I of 15 patients regularly attending rehabilitation and Group II of 18 patients practicing rehabilitation occasionally. Bilateral measurement of the angular range of motion in the shoulder was the basic method of assessment. A shoulder range of motion of the upper limb on the operated side smaller by more than 10° in relation to the opposite limb was regarded as ROM limitation. Upper limb circumferences were also measured at 10 cm above and below the lateral humeral epicondyle and in the central metacarpus excluding the thumb to an accuracy of 1 mm. Circumferences of the upper limb on the operated side greater by more than 2 cm compared to the opposite limb were regarded as lymphoedema. Our evaluation of statistical significance of correlations between qualitative parameters (influence of rehabilitation on limitation of the shoulder range of motion and incidence of lymphoedema) relied on the non-parametric Chi-square test (χ²).There was a statistically significant correlation between regular rehabilitation practice and the shoulder range of motion and persistence of upper limb lymphoedema on the mastectomy side.Physiotherapy improves ROM and effectively prevents deterioration of upper limb lymphoedema in post-mastectomy women.
Key words:
breast cancer, mastectomy, shoulder joint, range of motion, lymphoedema
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进行乳房切除术后妇女的淋巴水肿全疏通治疗

Marek Woszczak, Katarzyna Syrewicz, Iga Woźniak, Łukasz Goździewicz, Katarzyna Bogacz, Karolina Kossakowska

M. Woszczak, K. Syrewicz, I. Woźniak, Ł. Goździewicz, K. Bogacz, K. Kossakowska – Comprehensive draining therapy in the treatment of lymphoedema in women after mastectomy. Fizjoterapia Polska 2019; 19(4); 28-40

摘要
简介。乳癌为最危险的恶性肿瘤之一，该疾病的发病率持续增加中。因治疗和与之相关的淋巴结结构去除或破坏后的最常见并发症为淋巴水肿，改善状况的方法之一为实施综合疏通治疗（KTU）。
研究目的。该研究的目的在评估综合疏通治疗疗效，及其对淋巴水肿和活动性与紧握力的影响。
材料与方法。该实验在克尔采的圣十字肿瘤中心进行，对象为进行单侧乳房切除术后的60名妇女，她们被分入实验组和对照组两组。实验组中的30名女性接受KTU疗程，而另一组则接受改善治疗。疗程持续10天，在改善治疗前后以测角术测量运动范围，并以厘米胶带评估四肢周长并使用测力计测量SUR。
结果。疗程结束后两组的研究参数均获改善，然而实施综合疏通治疗的组效果更为明显，实验组的四肢周长缩小且紧握力及活动范围均有改善。
结论。所使用的两种治疗方法都能有效减少淋巴水肿，然而综合疏通治疗KTU为更有效的治疗方法。

关键词：
乳房切除术、综合疏通治疗、淋巴水肿

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Comparison of circumference of women’s upper limbs after radical breast amputation subjected and not subjected to early professional rehabilitation

Elżbieta Niedbała, Leszek Kołodziejski

E. Niedbała, L. Kołodziejski – Porównanie obwodów kończyn górnych u kobiet po radykalnym leczeniu raka piersi korzystających i nie korzystających z wczesnej profesjonalnej rehabilitacji. FP 2013; 13(4); 37-43

Abstract

Removing the lymphatic system of the armpit during the radical mastectomy hinders the outflow of lymph from the upper limb. Aim of the work. The aim of this report is to compare the circumference of women’s upper limbs post-surgical breast cancer undergone to early professional and unprofessional rehabilitation. Material and methods. A group of 146 members of Amazon Club subjected to radical breast amputation by Maddens methods between 2002-2009, have been evaluated. 71 patients from Malopolska (M group) were operated on in the Oncological Centre of Krakow (OCK) and 75 from Świętokrzyskie (Ś group) were operated on in the Świętokrzyskie Oncological Centre in Kielce (SCO). For all the patients the same, standard oncological procedures were used. The only significant difference between the medical centres was the method of conducting early post operative rehabilitation. In the M group it was conducted by trained nurses and volunteers of Amazon Club and the patients continued their exercises on their own at home. In Ś group a complex rehabilitation in the stationary conditions was conducted by professional physiotherapists. Data of all the women have been obtained including the patients’ age, past treatment and rehabilitation or the circumference of upper limbs were done. Women from both groups (M i S) were compared regarding antropometric features, past treatment and circumference of upper limbs and development of lymphedema. Results. In spite of the considerable difference in the method of early postoperative rehabilitation the patients from M i S did not differ significantly as regards circumference of their upper limbs, occurrence and volume lymphedema on the operated side.
Conclusions:
1. At women after radical mastectomy subjected to the early professional and unprofessional rehabilitation, in the late period of observation, the circumference of their upper limbs were the similar.
2. In both groups M i S the percentage of women with lymphedema was low.

Key words:
mastectomy, circumference upper limbs, lymphedema

Physiotherapy in the treatment of lymphoedema

Jacek Kultys, Teresa Pop, Ryszard Bielak

J. Kultys, T. Pop, R. Bielak: Physiotherapy in the treatment of lymphoedema. Fizjoterapia Polska 2015;15(3);64-77

Abstract

Lymphoedema is a chronic disease caused by the malfunction of the lymphatic system, leading to the accumulation of lymph in the interstitial space. The consequence of a primary or secondary lymphoedema is an unesthetical appearance of the limb, limited activity, and sometimes a significant distortion with a deformation of osteoarticular structures and muscle atrophy. Emotional problems often appear, affecting interpersonal relationships and the quality of life of the patients. A complete decongestive physiotherapy is still considered to be the most effective method of conservative treatment of lymphoedema, where a corresponding plan and implementation of the treatment throughout different degrees of severity of the disease brings good therapeutic results.
Key words:
lymphoedema, treatment, complex decongestive physiotherapy

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Possible applications of dynamic taping in women after the removal of lymph nodes because of breast cancer

Anna Lipińska, Magdalena Lipińska-Stańczak, Paweł Macek, Renata Szczepaniak, Sławomir Jandziś, Zbigniew Śliwiński

A. Lipińska, M. Lipińska-Stańczak, P. Macek, R. Szczepaniak, S. Jandziś, Z. Śliwiński: Possible applications of dynamic taping in women after the removal of lymph nodes because of breast cancer. FP 2015;15(4);16-31

Abstract
Introduction. In Poland and in the world breast cancer is the most frequent malignancy among women. Complications occurring after the applied therapy lower the quality of patients’ life. One of the many adverse effects of breast cancer treatment is lymphedema. Removal of lymph nodes and damage to lymphatic vessels make the transport of high-molecular proteins difficult, and at the same time, they have an influence on an increase in the colloid-osmotic pressure, water retention in the inter-tissue space, the loss of lymphatic vascular tone and reduction of the hydrostatic pressure. If not treated, lymphedema causes ailments in the form of recurrent inflammatory conditions of the skin, lymphatic vessels, which greatly reduces the patients’ psychophysical efficiency and promotes the development of lymphosarcoma of the upper limb on the side of mastectomy. One of the methods of lymphedema treatment is Kinesiology Taping. In Poland, the term dynamic taping is more and more frequently used. Application of this method causes that healing processes occur in the patient in a painless and natural way.
Aim. To present the possibilities of using lymphatic techniques of dynamic taping in women after mastectomy and to assess the impact of the applications on the secondary lymphedema.  The author decided to verify the main objective through the following research hypotheses:
1.Applications of dynamic taping reduce lymphedema in women after mastectomy.
2.Techniques of the Kinesiology Taping method influence the change of motion ranges in the joints of the upper limb.
Material and research methods. The study was performed in the Department of Rehabilitation of Holycross Cancer Centre in Kielce. The study group consisted of 73 patients after mastectomy diagnosed with secondary lymphedema of the upper limb. The volume of upper limbs was measured with the use of a measuring cylinder filled with water. Measurements of motion ranges in the joints of upper limbs were performed with the use of a goniometer.
Results and conclusions. Analysis of the results shows that the employed lymphatic applications reduce lymphedema, increase the range of motion in the joints of the upper limb on the operated side and promote healing processes, contributing to the improvement of physical efficiency and the quality of life.

Key words:
breast cancer, lymphedema, dynamic taping, Kinesiology Taping

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Opóźniona diagnoza i leczenie pierwotnego obrzęku limfatycznego kończyn dolnych – studium przypadku / Delayed diagnosis and treatment of primary lymphoedema of lower limbs – case study

Rita Hansdorfer-Korzon, Jacek Teodorczyk, Marcin Gruszecki, Michał Korzon

FP 2016;16(2);42-53

Streszczenie
Leczenie pierwotnego obrzęku limfatycznego stwarza wiele problemów pacjentowi jak i całemu zespołowi medycznemu. Całkowite wyleczenie bowiem z racji uszkodzenia anatomicznych dróg odpływu chłonki nie jest możliwe, a terapia ma na celu jedynie zmniejszenie rozmiarów kończyny, przywrócenie jej funkcji i poprawienie aspektów kosmetycznych. Leczenie jest trudne, wieloetapowe i nawet w przypadku dobrych wyników kosztowne i czasochłonne. Obrzęki pierwotne nie są patologią bardzo częstą, toteż problem związany z ich diagnostyką i leczeniem pozostaje często na marginesie zainteresowania lekarzy. W przeciwieństwie do dobrze zorganizowanej pomocy, jaką otrzymują chorzy z obrzękiem w obrębie kończyn górnych (głównie po leczeniu chirurgicznym raka sutka) możliwości rozpoznania, diagnostyki i wdrożenia postępowania usprawniającego u osób z idiopatyczną postacią obrzęku limfatycznego kończyn dolnych są istotnie ograniczone. Chociaż w ostatnich latach intensywnie propagowana jest wiedza dotycząca zasad stosowania terapii przeciwzastoinowej nadal w wielu ośrodkach wdrażana jest nieprawidłowo. Nieleczony lub niewłaściwie leczony obrzęk staje się nieodwracalny wskutek rozplemu tkanki łącznej, czym różni się od obrzęków na innym podłożu. Narastający obrzęk doprowadzający do stopniowej deformacji i zaburzeń funkcji kończyny, wpływa negatywnie na stan psychiczny pacjenta. Późne rozpoznanie, kosztowne, uciążliwe i długotrwałe leczenie, którego efekt jest niejednokrotnie niezadawalający wpływa istotnie na jakość życia chorego. W pracy przedstawiono jeden z licznych przypadków pacjentek z rozpoznanymi późno i nieprawidłowo leczonymi obrzękami pierwotnymi, które mają być ilustracją typowych zaniedbań w dążeniu do ustalenia diagnozy i wdrożenia leczenia w tej jednostce chorobowej. Podkreślono także rolę badania LS jako złotego standardu w diagnostyce obrzęków pierwotnych i jej ograniczonej przydatności w ocenie skuteczności leczenia.

Słowa kluczowe:
obrzęk limfatyczny, pierwotny wrodzony obrzęk limfatyczny, rehabilitacja, limfoscyntygrafia

Abstract
Treatment of lymphoedema is problematic for the patient and the entire medical team. Complete recovery, because of anatomical damage to the outflow tract of lymph, is not possible and the therapy is intended only to reduce the size of the limb, restore its function and improve the cosmetic aspects. Treatment is difficult, multistage, unpredictable and even if results are good, expensive and time consuming. Primary lymphoedema is not common disease, so the problem of its diagnosis and treatment is often on the margins of medical concern. In contrast to the well-organized support received by patients with secondary oedema of the upper, diagnosing and implementation of rehabilitation in patients with idiopathic lymphoedema of the lower limbs are significantly limited. Although in recent years is intensely propagated knowledge of the principles of anticongestive therapy, it is still is implemented incorrectly in many centers. If left untreated or improperly treated swelling becomes irreversible as a result of proliferation of connective tissue, what differs from cases of oedema not associated with lymphatics damage. Increasing swelling will lead to progressive deformity and dysfunction of limbs and negatively affects the mental state of the patient. Late diagnosis, costly, cumbersome and long-term treatment with the often unsatisfactory effect significantly affect quality of life. The paper presents one of many our cases of patients with late diagnosed and improperly treated primary lymphoedema and is an illustration of the typical negligence in establishing the diagnosis and initiation of treatment in this disease entity.

Key words:
lymphedema, primary congenital lymphedema, rehabilitation, lymphoscintigraphy

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Evaluation of Impact of the Application of Kinesio Taping and Standard Complete Decongestive Therapy on the Lymphedema in Women After Mastectomy

Jolanta Darowska-Olszewska, Zbigniew Śliwiński

J. Darowska-Olszewska, Z. Śliwiński – Evaluation of Impact of the Application of Kinesio Taping and Standard Complete Decongestive Therapy on the Lymphedema in Women After Mastectomy. FP 2016; 16 (3); 18-32

Abstract
Introduction. The objective of this study has been to evaluate treatment results in the upper extremity on the side after surgery, in women after the mastectomy procedure, with the application of the Standard Complete Decongestive Therapy and the Modified Complete Decongestive Therapy, where the multilayer bandaging has been replaced with the lymphatic applications of the Kinesio Taping method. The above objective has been verified by testing the following hypotheses:
1. Lymphatic applications of the Kinesio Taping method can replace the multilayer bandaging.
2. Kinesio Taping techniques affect the range of motion in the shoulder joint.
3. Kinesio Taping applications reduce pain in the upper extremity, on the side after surgery.
Materials and Methods. Total number of 24 women after the unilateral mastectomy have been examined. The test group encompassed 12 patients, to whom the lymphatic Kinesio Taping techniques have been applied. The control group constituted of 12 patients, who have been treated with the multilayer bandaging. Both groups, over the period of 15 days, have been subjected to a 30-minutes manual lymphatic drainage procedure and to 20 minutes of rehabilitation exercises. Before and after the therapy, the upper extremity circumference has been measured using a centimeter tape. The shoulder joint range of motion has been measured with a goniometer. The pain level has been assessed according to VAS scale.
Results. Analysis of the obtained results show, that the lymphatic tape applications used reduce lymphedema and pain sensation, and increase the range of motion in the shoulder joint on the side after surgery, in women after the mastectomy procedure.
Conclusions. The applied Kinesio Taping techniques, when compared with the multilayer bandaging of the Complete Decongestive Therapy, bring about the comparable results.

Key words:
lymphedema, Kinesio Taping, Complete Decongestive Therapy

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